Treating dental pain with opioids linked to higher risk of overdose in patients & families
A new study published in The American Journal of Preventative Medicine is showing a link between the prescribing of opioids after a dental procedure and overdosage not only in patients but also their families. The big data study was undertaken as an ongoing collaborative between Michigan’s schools of medicine and dentistry as a part of the Michigan Opiate Prescribing Engagement Network (OPEN). They reviewed dental procedures in teen/adult patients between 2011 and 2018 whose care was covered by public or private dental insurance. Nearly 27% of these patients filled a prescription for an opioid such as hydrocodone or oxycodone.
The researchers identified 2,700 overdoses that occurred in the 90 days after a tooth extraction or 119 other dental procedures. That’s about three overdoses for every 10,000 dental procedures. The rate was 5.8 per 10,000 among those who filled an opioid prescription within three days of their procedure, compared with 2.2 per 10,000 among those who didn’t. Their findings also suggest that 1,700 overdoses a year could be happening because of dental opioid prescriptions.
The study also reviewed overdoses within 90 days in the patients’ family members. The rate of overdose was 1.7 per 10,000 procedures in family members of privately insured patients who filled opioid prescriptions, compared with 1 per 10,000 procedures among those who didn’t.
It’s in the public’s best interest that all health care providers are more judicious in their opiate prescribing behaviors and it leads one to question the authors objectives. In the opinion of this author, to focus only on Dentistry is to ignore the impact of other healthcare domains to public health.David MH Lambert, DDS
In the study, 400 family members of patients were treated for opioid overdoses in the 90-day period after the dental patient’s procedure. In all, 42% of these overdoses were in the child of the patient who had a procedure, and another 25% were in a spouse; the rest were in parents and siblings.
This study is yet another installment in a series of investigations on behalf of University of Michigan investigators Kao-Ping Chua, M.D., Ph.D. and Romesh Nalliah, DDS. While their results provide important information, an important, but yet missing perspective, is the relationship of these data in comparison to other health care domains. Such review may provide similar results which may be instructive. It’s in the public’s best interest that all health care providers are more judicious in their opiate prescribing behaviors and it leads one to question the authors objectives. In the opinion of this author, to focus only on Dentistry is to ignore the impact of other healthcare domains to public health.